良恶性食管狭窄患者放射治疗后致食管支架置放困难及对疗效的影响

Implantation of esophageal stent after radiotherapy:a study of feasibility

目的 总结放疗前后行有效食管扩张及支架置放的疗效。方法 未行放疗及放疗后两组均用锥形塑料探条扩张器扩张食管狭窄段，扩至１３ｍ ｍ 时采用置入器置放支架。结果 ５３ 例中未行放疗的 ３０ 例，扩张均为显效，显效率达１００％ （３０／３０），支架均１ 次顺利置放成功，成功率达 １００％（３０／３０）；行放疗的 ２３ 例中扩张及支架置放的总有效率仅为 １７３９％ （４／２３）；未行放疗组和放疗组扩张的显效率，支架置放的成功率二者差异非常显著（ Ｐ ＜ ０００１）。同样术前，术后进食标准积分的改善率差异也非常显著。结论 对既需要放疗，又需要支架置放的患者，应先行支架置放，后行放疗，以提高成功率。

Objective The influence of radiotherapy for benign or malignant esopageal stricture on effective dilatation and stent implantation was observed.Methods 53 patients with esophageal stricture were enrolled into the study.Results With no radiotherapy(n=30) the rates of success in stenotic dilation and stent implantation at first attempt attained 100 per cent while the rates,after irradiation(n=23), dropped to 17.39%(4/23) with significance(P<0.001).Statistical difference was also seen in clinical improvement as expressed by standard eatingscore.Conclution It is suggested that the stent should be implanted prior to radiotherapy if necessary.